Hampshire Suicide Prevention

Strategy

Simon BryantInterim Director of Public Health

Hampshire County Council

Aim

This strategy outlines the Hampshire approach to suicide prevention which requires statutory agencies, the

voluntary sector and others, including the media, to work together to reduce the number of suicides and the effect of

someone taking their life.

Achievement of the Five Year Forward View target for reduction

of suicide (10% by 2020/21) from a 2015/16 baseline.

Every day in England around 13

people take their own lives.

The effects can reach into every

community and have a devastating

impact on families, friends,

colleagues and others. Each one of

these deaths is a tragedy.

Every local area, whether its own

suicide rate is high or low, should

make suicide prevention a priority.

ThemesReduce the risk of suicide in key high-risk groups

Tailor approaches to improve mental health in

specific groups

Reduce access to the means of suicide

Provide better information and support to those

bereaved or affected by suicide

Support the media in delivering sensitive

approaches to suicide and suicidal behaviour

Support research, data collection and monitoring

The latest suicide and injury

undetermined mortality rate

(2014-16 data) for Hampshire

is 8.4 per 100,000 population

(n=303) this is statistically

significantly lower than the

England rate of 9.9.

Rates of suicide

For every person who dies by suicide 135

people who knew the person will be

exposed. Each suicide affects a large circle of

people, who may be in need of clinician

services or support following exposure.

The suicide rate is higher for males,

with a male: female ratio of 3:1,

however trend data suggest a

decrease over the last few years for

male rate which is now lower than

the national rate but a flattening of

the female rate which is

comparable to the national rate

At district level rates fluctuate between

5.6 per 100,000 in Eastleigh to 11.2 per

100,000 in Test Valley; Data for 2014 to

2016 show rates are significantly lower

than the national rate in Eastleigh

Fareham and the New Forest.

The other districts rates are not

significantly different to the national

rate.

Males

Females

Why

conduct a

local

audit?

• PH have access to nationally produced

data

• Public Health Mortality Files

However…

• Lack contextual information

• Audit isn’t about counting numbers it

is about the person, circumstances,

themes identifying risk factors.

• Enables an evidence based suicide

prevention strategy and action plan

Audit: Summary data 2014 to 2017.

A total of 344 deaths which occurred between 2014 and

2017 have been audited.

245 recorded had the person’s ethnicity recorded, 89% were White or White British, eight

people (3%) were Asian/Asian British

18 people were in current or recent contact with the criminal justice service. Twelve people

were on bail, seven of these were under investigation for

sexual offences.

Overall, the majority of cases (60%) audited died by suicide at

home, however location of death data for people aged under 24 years shows the

majority (65%) died elsewhere.

Hanging was the most common method with over half of the

cases (55%, n = 190) using this method, 17% (n= 57) died due

to a drug overdose and 5% (n=18) jumped onto train

tracks/into a train.

Audit: Demographic data

130 (38%) people were

single.

Almost one third

(n=39) lived alone.

One quarter (n=85)

were either divorced

or separated.

Almost two thirds

(65%) lived alone

7% (n=25) were

widowed.

Three quarters (76%)

lived alone.

Ages ranged from 13 years to 90 years.

The average age over the three year

period was 47 years.

A total of 254 cases (74%)

were male.

The majority of both male and

female cases are aged between 40

and 54 years, however there was a

peak in the males aged 20-24 age

band.

Audit: Method analysis

• Analysis by method and age suggest differences in method, with a higher proportion of

younger people dying elsewhere.

• Hanging was the main method for all ages however a larger proportion of younger

people died by either jumping from height or onto train tracks or train when compared

with the older age bands.

Audit: Services involved

92 (27%) were in contact with

mental health services at the

time of their death

28 (8%) had been in contact

with mental health services in

the last 12 months

18 (5%) had been in contact

with mental health services in

the last 2 years

58 (17%) had been to see their

GP two weeks before their

death.

Almost one third (29% n= 101)

had documented reports of

substance misuse within the

last year. 19 people (6%)

reported having used drugs in

the last 24 months.

33% misused both drugs and

alcohol

Eight were in contact with

substance misuse services at

the time of the death and four

had been in contact with them

up to 12 months prior to

death.

Self harm incidents and audit data

Between March 17 and February 18 SCAS attended 2,935 callouts

where the chief complaint was recorded as deliberate self harm,

overdose or substance abuse.

There were a higher proportion of female deliberate self harm

ambulance incidents. 59% of all incidents were female. The age

profile was much younger than the suicide data; self harm

incidents were highest in the 18-24 year old male and females.

Havant followed by Gosport had the highest incident rates

across the districts.

Audit: Children and young people (under 25 yrs old).Over the four year period 2014 to 2017 there were 48 suicides by children and young people

(under 25 years) in Hampshire which were audited.

39 (81%) were males, 9 (19%) were females

60% (n=29) of young people lived with parents.

13% (n=6) lived alone

The majority of the young people were either students (23%, n=11) or employed (48%, n=23).

Suicide prevention in HampshireKey achievements

Postvention protocol for schools/colleges

Real time surveillance with Police and Help is

at Hand distributed to key locations

EU Step by Step project

to improve men’s

….mental health

Leaving prison work –improving support

available for ex prisoners.

Suicide prevention training for frontline

workers

Developing work to support LGBT

communities through schools and local

events

Partnership work with South Western

Railways including visits to high risk

locations

Connect 5 training –Community Resilience

How has this research informed the

Hampshire suicide prevention work?

Suicide

Prevention

Training

Access to

the means

Vulnerable

Groups

Suicide Prevention & Mental Health

Training

Training for Primary Care

Samaritans Training for Frontline Practitioners

Online/free training such as Zero Suicide Alliance

Men and Health Inequalities

Further research into why men are at higher

risk of suicide showed that

• Men are less likely to access health

services and/or delay seeking help

• Men engage in health topics differently to

women

• Stigma around mental health as

‘weakness’ prevented men from talking

about their mental health

• Men are happier to engage in a physical

or social activity than an ‘health service’

SBS Overview• European Regional Development Fund (ERDF) funded project with 10

project partners

• Development of a new model of health and wellbeing improvement,

based on the way men naturally engage with each other, in places

where men naturally meet – inspired by Men’s Sheds

• Coproduced with men in each partner organisation

• Combines mental health and physical health to reduce stigma and

increase engagement

• Addresses key contributors to poor mental wellbeing among men –

improving social connectivity, being able to contribute, improving

confidence

• Includes employment as a key factor in men’s health and wellbeing –

addressing suicide risk factors of debt / redundancy

Model overview: https://www.youtube.com/watch?v=zZhTi1y2Z0s

Working with Prisoners/ex-

Offenders

• Listening service provided by Samaritans

• Discharge pack

• Work in progress with Prison staff –substance misuse/mental health/social care

Vulnerable Groups

People with Mental Illness

• Working with secondary mental health

providers/trusts to develop the zero suicide

ambition.

• Population approaches such as commissioning

services from MIND

Vulnerable Groups

Those who are bereaved by suicide

• People bereaved by suicide can be many times more likely to attempt suicide themselves and are particularly vulnerable.

• Postvention/prevention Protocol for Schools & Colleges, offering support and key steps http://documents.hants.gov.uk/public-health/2018-02-20SuicidePreventionandPostventionProtocolforSchoolsandColleges.pdf

• People with Lived Experience (PLE) workshop work to develop greater understanding of the needs and to develop system to incorporate PLE in planning

Vulnerable Groups

Reducing Access to the Means

Access to

the

means

Real Time Surveillance

In November 2017 a police led suicide surveillance programme

commenced in Hampshire.

There are two main reasons for PH to be involved in the real time

surveillance programme;

– postvention bereavement support.

– Identify any trends in location, method and cohort early to

prevent subsequent deaths or copy cats.

These data must be treated with caution as they cannot be recorded

as a suicide until after the coroners inquest and subsequent verdict,

therefore can only be referred to as suspected suicides.

Governance

• Multi Agency plan and group chaired by Public

Health

• Strong links to the Safeguarding Boards

• Feedback to the Crisis Care Concordat

• Sign off by the Health and Wellbeing Board

Thank you for listening!

Any Questions?